<form id="add-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label for="c-channel_merchant_no" class="control-label col-xs-12 col-sm-2">{:__('渠道商户号')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-channel_merchant_no" data-rule="required" class="form-control" name="row[channel_merchant_no]" type="text" value="{$row.channel_merchant_no|htmlentities}">
        </div>
    </div>

    <div class="form-group">
        <label for="c-channel_merchant_no" class="control-label col-xs-12 col-sm-2">{:__('渠道终端号')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-channel_terminal_no" data-rule="required" class="form-control" name="row[channel_terminal_no]" type="text" value="{$row.channel_terminal_no|htmlentities}">
        </div>
    </div>

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed">确认</button>
        </div>
    </div>
</form>